Purpose:
With the rapid rise of e-health and remote care systems, we sought to evaluate perspectives on and familiarity with telemedicine among eye care providers (ophthalmologists and optometrists) and emergency department (ED) physicians at a large tertiary care medical center.

Methods:
Anonymous surveys were administered to eye care providers and ED physicians at the University of Michigan to gauge current practice patterns and willingness to adopt telemedicine for eye care. Results were compared among trainees (residents and fellows) and faculty members and across specialties.

Results:
A total of 76 ED physicians (55.1% trainees, 42.3% faculty, 2.6% physician assistants and others) and 58 eye care providers (31.0% trainees, 69.0% faculty) completed surveys (response rates of 72% and 62%, respectively). Among eye care providers, while a majority of both faculty and trainees were willing to participate in telemedicine services, trainees were more likely to be willing to interpret photographs than faculty (p=0.04). Most respondents (71%) indicated that they did not use telemedicine, yet over half received photographs (via internet or email) for interpretation from referring physicians (54%) or patients (56%) within the past 3 months. At the same time, a majority (59%) had low confidence in remote screening for eye care as the only source of information for patient care. Among ED physicians, 65% were already utilizing telemedicine for various specialties, and most were interested in tele-ophthalmology. A majority (80%) felt telemedicine in eye care was under-utilized in the ED. Interestingly, ED faculty were more likely than trainees to feel confident in using telemedicine services to decide upon appropriate patient eye care without an in-person ophthalmology consultation (p=0.01).

Conclusions:
While many providers see telemedicine as part of the future of eye care and its use is accepted by most, the majority of eye care providers (but not ED providers) had confidence issues regarding the use of telemedicine services alone in the care of patients.